Although Push Doctor stressed plans were in early stages, the company said it was seeking to work with multiple GP practices across multiple CCGs.

Founder and chief executive Eren Ozagir said: ‘As a category leader with unrivalled UK experience in delivering high quality regulated digital healthcare we continue to explore, with stakeholders at a local and national level, how we may work together to bring Push Doctor's unique levels of speed, availability and convenience to NHS patients and at the same time greater efficiencies in the provision of care.’

Medical director Dr Mobasher Butt said: 'We're looking at sites all over the country. Obviously any of the major cities would be great locations.'

The comments come as board papers from NHS Hammersmith and Fulham CCG, where GP at Hand’s London host practice is based, had said Babylon Health planned to launch its NHS service elsewhere ‘in July 2018’.

Readers' comments (28)

I have to declare a conflict of interest here as I founded an online service which offers GP telephone and email consultations; and very importantly, access to gynaecologists by phone. My GP trainees have just changed over after 4 months with us. I barely had time to get to know them. They can barely have had time to touch the surface of O and G. How can they really provide good care in the community with such a short experience? I asked at the LFG 'Surely it should be extended back to 6 months?' but was told that women's health is not even compulsory. Is it small wonder that the most ridiculous referrals for next to nothing are made to the hospital and huge numbers of unnecessary scans are requested? This all costs a huge amount of money and wastes women's time and their employer's money. It almost certainly contributes to the Gender Pay Gap or as I call it, the Gender Career Progression Gap. Surely access to specialists remotely is the right thing, saving the face to face for when it's needed. It can be done safely and should be done.

We’ve been told by our CCG that we have to engage in e-consult. My concerns are that is makes us available 24/7 and there is no extra money to deal with this extra demand which may reduce OOH/111 input. What about indemnity effect?

Comments on AI - I think we may become supervisors/consultants with AI. Clinical examination can be invaluable and currently needs a clinician. I think e’re a generation away from any radical change here.

I agree and would go further. All consultations should ideally be done by phone or Skype / Video link first in both General Practice and Hospital.

Having been part of a referral management centre in the past, I also agree that many GP referrals appear to be inappropriate. However one has to look at the reasons for referral. Lacking the knowledge is NOT the main reason. Here are some other reasons:

The patient wants a second opinion and sees the GP as a referral portal to real Doctors.The patient has multiple complicated symptoms that require a lot of time, something that GPs do not have. GPs are not paid directly for their time.Some GPs do not have access to certain scans...The patient has private health insuranceOften GPs with the most knowledge refer more because they worry about rare conditionsIn the modern world of complaint culture many GPs worry about litigation. They too are inundated with what experienced GPs feel are inappropriate referrals from nurses, pharmacists, care homes. The threshold to consult has changed and we are all equally busy.It can be stressful blocking a referral that a GP knows is not required and can cause a breakdown in the Doctor / patient relationship. This can be less of an issue in secondary care where the respective patient may not be seen again.Being the last to hold the buck is not pleasant.

Spot on Tony, combined with a decade of decreased funding in real terms and an end of days recruitment crisis to name but two of many negative issues affecting general practice.Any surprise we are in a death spiral.

Another point: If your GP trainees spent most of their time doing Out Patient clinics while being supervised by seniors, rather than on the wards, they would have ample time to gather enough experience in four months. When I was in Canada, years ago, that was how GPs were trained.

That's the problem with junior hospital posts, it is more about service rather than training - we would need more consultants for it to be truly consultant led and also more IT in hospitals. But the consultant job would be even more harder.

could they stop sending them to A^E when they don't know what to do with them and the patient is registered but lives 100s of miles away. fed up of dealing with rashes that have been present for 4 weeks or more - not joking, sent to A^E by these companies rather than referred to a local GP service. patients are totally confused how to access services. mind you 111 is even worse.

Theres lots of expertise and plenty of good ideas on how things should be organised that to me is clear, the problem I feel is an absence of sensible coordination at the macro level. This is primarily because macro level coordination is in the hands of politicians with little understanding of basic science. Their primary concern is short term popularity, and they rely on home spun ‘common sense’ and the ‘advice’ of politically appointed ‘experts’ who often have expertise in completely the wrong field (Lord Darzi being a perfect example). It’s a consequence of the fact the NHS is funded out of taxation and it’s difficult to argue against political control of how the money is spent. We need to find a way to prevent politicians using the NHS as a popularity and vanity tool. The biggest problem the NHS has is the vanity and ignorance of politicians.